Category Archives: Health tips

Wear a helmet every time you ride a bike, skateboard, scooter or use in-line skates.

Children’s has one of the busiest pediatric emergency programs in the country, with about 90,000 visits each year. We love kids here at Children’s, but we’d rather see them safe at home. With warm weather upon us, we compiled a list of basic tips, with help from our injury prevention experts, to keep kids safe all summer. Together, we can make safe simple.

Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Erin Fritz, RN, CNP

The snow has now melted and the temperatures are rising, allowing our energy and activities to bring us outdoors. Spring weather brings sprouting trees, blooming flowers – and creepy crawly ticks that lurk in the woods, grass and marshy areas.

Whether you are heading up north to the cabin or playing in your backyard, ticks may be present and a tick bite may occur. Due to the extreme seasonal temperature changes and high humidity, Minnesota has a lot of ticks and high rates of tick-borne illness such as Lyme disease, and the risk remains high. Lyme disease is an infection caused by bacteria that is carried by some deer ticks. Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Prevention

Playing outdoors increases the risk of encountering a tick, but there are ways to prevent a tick from attaching and biting. The American Academy of Pediatrics recommends the following for tick and Lyme disease prevention:

Cover arms and legs by wearing long-sleeved shirts and pants tucked into socks

Wear a hat to cover hair

Wear light-colored clothing in order to see ticks more clearly

Wear enclosed shoes, use insect repellent with DEET

Stay on cleared trails whenever possible

Routinely check for ticks immediately after coming indoors

When you find a tick

Most ticks are noticed when crawling around on clothing or skin and easily can be removed by taking it off before it attaches to the body. If a tick already has attached, removal is rather easy and should be removed as soon as possible. While prompt removal is important to decrease the risk of developing Lyme disease, be aware that most medical experts agree that the tick must be attached for at least 24-36 hours before Lyme disease is transmitted.

In order to remove the tick:

Simply grasp the tick with a tweezers as close to the skin as possible

Without squeezing the tick’s body, slowly pull the tick away from the skin

Clean the bitten area with soap and water

Apply an antiseptic ointment

Be on the lookout

After tick removal, it’s important to monitor the site for expanding redness that might suggest a “bull’s eye” rash. This particular rash can be the first and most obvious sign of Lyme disease. The rash usually doesn’t cause other symptoms, but burning or itching is a possibility. Further examination by a health care professional is needed if there is a bull’s eye rash, headaches, chills, fever, fatigue or muscle aches. If Lyme disease is suspected, a health care professional probably will prescribe an oral antibiotic for treatment. There’s no benefit in testing for Lyme disease at the time of the tick bite; even people that become infected will not have a positive blood test until approximately two to six weeks after the infection post-tick bite. Early identification and treatment is important to reduce the risk of worsening illness.

While ticks and tick-borne illness easily can be overlooked, prevention is vital. This is the time of year to take full advantage of the long-awaited summer. Get outside and play safely.

Erin Fritz is a certified nurse practitioner at Children’s Hospitals and Clinics of Minnesota.

To combat testing anxiety, students should have some go-to solutions such as engaging in a brief relaxing activity, outlining notes or playing a memory game. (iStock photo / Getty Images)

Guest post by Maggie Sonnek

Mae Hyser is one smart cookie. At 12 years old, she already has her career planned out: become a writer and an illustrator. And mom Beth couldn’t be prouder.

“She’s kind of a Type-A personality,” Beth Hyser laughs. But, as end-of-the-year finals and projects approach, sixth-grader Mae is aware of the extra pressure. And so is her mom.

Are your kids stressed over tests? Here are some tips to help kids like Mae – and their parents – decrease stress and improve results.

Set up good study habits at an early age

It sounds obvious, right? Michelle Goldwin, MA, doctoral psychology intern at Children’s, says developing effective study habits earlier is a way for kids to feel more confident about their abilities to study and take tests.

“We’re noticing kids are becoming nervous about tests earlier and earlier,” she explains. “There are more standardized tests sooner; kids are learning that they have to do well in order to get good grades…to get into a good college…to get a good job.”

To combat that anxiety, students should have some go-to solutions at the ready, such as engaging in a brief relaxing activity, outlining notes or playing a memory game.

Create a positive bedtime routine

Bedtime can be the hardest time of the day for parents. But, it doesn’t have to be. Mary Sheedy Kurcinka, MA, writes about practical strategies for getting a good night’s sleep in her book, Sleepless in America.

“Researchers have discovered that the sleep/wake cycle, or what researchers like to call the circadian rhythm, runs on a cycle closer to 25 hours than 24,” she writes. “In order to bring your child’s cycle into line with a 24 hour day, you have to set it with cues, like light and a regular sleep-and-wake schedule.”

For 12-year-old Mae that reward is a few coveted minutes on the iPad, which mom will gladly hand over after she practices her spelling words.

Value your child’s self-worth

Both Goldwin and Beth Hyser expound on the importance of valuing kids beyond the report card.

Goldwin says, “Parents can remind their kids, ‘I like that you’re working hard on this and giving it your all.’ But, be sure to remind them that they’re also a great artist or bowler. There are lots of special things about each child.”

Beth Hyser agrees. “If a C is your best, then that’s great.”

Change the way you think

Goldwin and the rest of the team in Psychological Services at Children’s utilize Cognitive Behavioral Therapy as a way to help patients with anxiety.

“We encourage students to pay attention to their negative thoughts, like ‘I’m not going to do well on this test’ and replace them with more helpful thoughts, like ‘I’ve studied and I feel confident that I know this material.’ ”

Practice self-care

This means eating a hearty breakfast the morning of a test, staying away from caffeinated beverages and paying attention to breathing.

“Before the day of the test, I encourage kids to practice deep breathing by placing a hand on their bellies,” Goldwin says. “Then, slowly breathe out and notice that their belly deflates.” She adds that sometimes she draws the analogy of the stomach being like a balloon that’s filling with air and then emptying.

Lessening testing anxiety may not always be easy for kids, but these strategies can get them started on the path to a less stressful testing season.

In what ways do you work with your kids to lessen anxiety before tests or other stressful times? Share in the comments.

Summer is around the corner, we promise. No matter how much it snows in the next few days, the warm weather isn’t far away.

The season brings neighbors together for all kinds of outdoor activities. While your local barbecue or block party is a great time to reconnect with neighbors and enjoy a potluck, it’s also a great chance to review home and neighborhood safety tips with your children.

Here are five tips to bring up with your kids ahead of summer:

1. Post important personal and contact information in a central place in your home.

For teens, one visit to a tanning bed increases the risk of squamous cell carcinoma by 67 percent. (iStock photo / Getty Images)

A guest post by Gigi Chawla, MD

Every spring, many of us weary from a long winter head south to warmer climes; teens across the country attend prom with their sweethearts. And what do kids tend to do before events like these?

Hit the tanning salon.

Looking “pasty white” in a swimsuit or a new dress just won’t do, right? Think again.

Here’s a brief warning to help dispel the myth of “getting a base tan” before these events. Or ever.

Currently, 35 percent of 17-year-old girls in the U.S. are using tanning beds and 55 percent of college-aged kids have used one at least once.

In Minnesota, the Star Tribune reported earlier this year that, “a third of white 11th-grade Minnesota girls have tanned indoors in the past year, according to a state survey … and more than half of them used sun beds, sunlamps or tanning booths at least 10 times in a recent 12-month period.”

What isn’t immediately clear to our kids is that during a tanning-bed session they may receive up to 12 times the ultraviolet (UV) exposure as they receive being outside in the natural sunlight. This UV radiation exposure from tanning beds is dangerous and linked to three types of skin cancer: melanoma, basal cell carcinoma and squamous cell carcinoma.

Here’s the potential damage that one tanning-bed session alone can cause a teen:

The risk of developing melanoma increases by 20 percent

The risk of developing basal cell carcinoma increases by 29 percent

The risk of squamous cell carcinoma increases by 67 percent

For people using a tanning bed under the age of 35, the lifetime risk of developing skin cancer of any type increases by 74 percent.

Specifically, it increases the lifetime risk of:

melanoma by 75 percent

basal cell carcinoma by 150 percent, and

squamous cell carcinoma by a whopping 250 percent

Moreover, skin cancer now is the leading form of cancer in 25- to 29-year-olds.

Another startling fact: More skin cancer cases arise from tanning-bed use than lung cancer cases do from smoking; yet, in our culture, bronzed skin is seen as a form of beauty.

Some advice to parents: Remember to reinforce to your teens that they are beautiful or handsome no matter the shade of their skin. What’s important is what’s inside. I like to think that we live in an era in which we can look past skin color, where we are not judged by skin color and we should not see beauty based on skin color.

It’s time to remind your kids to “go with your own natural glow.”

Gigi Chawla, MD, is a pediatrician, hospitalist and the Senior Medical Director of Primary Care at Children’s Hospitals and Clinics of Minnesota. Her areas of interest are the care of complex special needs patients, premature infants, ventilator dependent children and care of hospitalized patients.

Hands-on play, where a child uses his or her imagination and ideas to self-discover, creates the best learning environment. (iStock photo / Getty Images)

By Jeri Kayser

When people try and remember the name of my profession, child life specialist, they often shorten it to “play lady.” That used to bug me when I was a young professional and ready to solve all of the world’s problems, but now I recognize the compliment. We breathe, drink and eat to stay alive – we play to bring forth a reason for all of that effort. Play is how we learn about our world, practice that knowledge and foster our sense of well-being and personal joy; it’s an honor to promote play in the world of health care, but it’s not without its challenges.

One current challenge is tied to the hot topic in popular culture about the value of gaming devices. Is playing a game on a smartphone when you’re 2 years old considered quality play? Short answer: No. The Academy of Pediatrics recommends no screen time for kids 2 and younger and only one to two hours a day for older children. The core aspect of the definition of “play” is that it’s self-directive. You’re deciding what you’re going to do with whatever you’re interacting with. One of the problems with electronic games is that game designers have done most of that for you.

Your toddler recognizes the status that phone holds, and it works for a bit to keep a child distracted from the fact that he or she is in the hospital or in a long checkout line at the grocery store.

So what can we use to help guide our decisions to promote healthy play? A great way to look at this is similar to how we all work to promote healthy choices for our diet. Potato chips are fine for an occasional treat, but we wouldn’t want to eat them all the time. If we did, we’d feel awful. Video games kind of are the junk food of play. The more the play requires from the child, the better the value and healthier the choice.

I notice this in the hospital when I come into a room to meet with a family about what to expect with surgery. People often are busy with an electronic device, but as soon as we start to talk, the interest is there to engage and the devices get turned off. When I bring a toy or some arts and crafts activities, kids always gravitate towards that; they want what they need.

I used to work in a summer daycare program for school-aged kids. We would spend the morning on a field trip and the afternoon at a beach. The director wanted us to provide structured activities for the kids in the afternoon, but we quickly learned that the combination of water, sand and friends led to a more-creative, imaginative and enriched play than anything with which we could have come up. Hands-on play, where a child uses his or her imagination and ideas to self-discover, creates the best learning environment.

I heard an interesting story on public radio on my long commute home. At the electronic show in Austin, Texas, at the South by Southwest conference, the big news at the conference was the “Maker Movement,” stressing the importance of hands-on play to promote understanding of how our world works. They interviewed an inventor, Ayah Bdeir, who created a toy of electronic bits that fit together with magnets, creating circuits. With this process, you can make all kinds of fun things. He explained the value of this explorative play by stating, “We need to remember that we are all makers and touching things with our hands is powerful and inspiring.”

In another century, another scientist noted the same thing. Albert Einstein declared, “Play is the highest form of research.”

Self-directed play offers the healthiest value for our play “diet,” and this extends throughout our lives. We all need to play. As I wrote this, I overheard a conversation between two anesthesiologists talking about how they used play to help them cope with life stressors. One likes his guitar, while the other enjoys making remote-control helicopters.

This important fact, one of the highest forms of self-care, needs to be part of the planning of how we provide health care. Play is important for all age groups, not just those adorable preschoolers. We need to incorporate this in everything we do, for teens, parents and staff.

Late Irish playwright George Bernard Shaw said it best: “We don’t stop playing because we grow old; we grow old because we stop playing.”

Jeri Kayser is a child life specialist at Children’s Hospitals and Clinics of Minnesota.

With one of the busiest pediatric emergency medicine programs in the nation and more than 90,000 emergency department visits annually for a variety of reasons, you can trust we’ve treated just about everything. We love kids here at Children’s, but we’d rather see them safe at home.

In recognition of Poison Prevention Week, we’ve gathered tips from our experts. Share these tips with your kids and print them to share at their schools or with your friends. Together, we can make safe simple.

Keep all potential poisons up high and out of the reach of children — in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze. (iStock photo / Getty Images)

What is Poison Prevention Week?

National Poison Prevention Week was established by Congress in 1961 for annual, national recognition. The goal of the week is to educate the public about poisoning risks and what to do to prevent poisonings.

What you should know

Did you know that injuries are a leading cause of death in children? Each year 5,000 children die and another 6 million are hurt as a result of unintentional injuries. One in 4 children is hurt seriously enough to need medical attention. Most childhood injuries occur at home and many of these injuries, including poisoning, could be prevented.

Facts about poisoning

More than 1 million accidental poisonings per year occur in children younger than 6 years old.

Approximately 1 in 10 poisonings involves cleaning products.

Approximately 1 in 10 poisonings involves indoor and outdoor plants.

Approximately 1 in 20 poisonings are caused by cosmetic and personal-care products.

Keep all potential poisons up high and out of the reach of children — preferably in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze.

Keep medications and vitamins out of the reach of children. Never call medicine “candy.”

Keep foods and household products separated.

Keep products in original containers. Do not use food storage containers to store poisonous substances (i.e. plant food in a drink bottle).

Destroy old medications.

Identify all household plants to determine if poisonous.

Post the Poison Center phone number, 1 (800) 222-1222, near each phone in the home.

What do you do if you suspect someone has been poisoned?

Swallowed poison: Remove anything remaining in the mouth. If a person is able to swallow, give about 2 ounces of water to drink.

Poison in the eye: Gently flush the eye for 10 minutes using medium-warm water.

Poison on the skin: Remove any contaminated clothing and rinse skin with large amounts of water for 10 minutes.

Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. (iStock photo / Getty Images)

By Karen Johnson, RN, CNP

Getting enough sleep is essential for your child’s growth and health. Studies show that many children don’t get enough sleep each night. This can result in behavioral problems, mood swings and poor school performance. A lack of sleep also can cause problems with memory, concentration and problem solving.

Occasional bouts of sleeplessness or restless nights are normal for kids as their bodies and brains develop, and the tips below can help you ensure your kids are getting enough rest.

But sometimes your child may not be getting enough sleep due to a sleep disorder. One of the most common sleep disorders in children is Obstructive Sleep Apnea (OSA). Signs of OSA in children are loud snoring, restless sleep, gasping and hyperactivity when awake. Risk factors for having OSA in children are having enlarged tonsils or adenoids, being overweight or certain other genetic or health disorders. Speak with your child’s health care provider if you think that your child might have OSA.

Here are some tips for helping your kids get a good night’s sleep:

Create a soothing and regular routine for sleep: A routine can help your child get ready for bed much easier. Studies show that children who have a bedtime routine wake up fewer times during the night. The bedtime routine should be the same every night, such as reading one book and singing one song, not lasting more than 15 to 20 minutes.

Maintain a consistent bedtime and wake time: Keeping the wake time and bedtime the same, even on weekends and vacations, is important to help maintain circadian rhythm.

Be conscious of light and darkness: Both are very influential in sleep-wake cycles. Bright light in the morning is influential in setting the circadian rhythm and helping children wake easier. Opening the curtains in the morning to let in the sunlight is the most powerful source of light; artificial light can be helpful as well. Dim the lights in the evening prior to the bedtime routine to cue your child’s internal clock that it’s time for sleep.

Keep electronics out of the bedroom: The light from televisions, computer screens, video games and mobile devices like cellphones can prevent your child from sleeping. It’s best to turn off all electronics at least one hour before bedtime, and in their place, do a calming activity such as reading or coloring.

Naps are important: Younger children need regular and predictable naps during the day. When your child is napping only once a day, don’t let him or her nap late into the afternoon, as this will interfere with the child’s ability to fall asleep at the regular bedtime.

Teach your child how to self-soothe: At an early age, put your child into his or her crib or bed when he or she is drowsy but still awake. Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. Children naturally wake two to six times a night, and if they do not know how to self-soothe, they will cry to alert you that they are awake. Not only does that disrupt their sleep, but yours as well.

No caffeine allowed: Caffeine is not recommended for kids, but if you allow your child any, make sure it is before 3 p.m., as it can delay the onset of sleep at bedtime.

Consistency is key to success: Be patient and persistent, as the investment is well worth it when your child is sleeping better.

Make sleep a priority for your child and family: Teach your child about the importance of sleep by being a good role model in your own sleep habits.

Karen Johnson, RN, PNP, is a nurse in the Children’s Sleep Center at Children’s Hospitals and Clinics of Minnesota. Her interest in pediatric sleep medicine stems from her passion to assist children in improving their sleep. She views sleep as a necessary function so that children can be alert, focus in school, reach their learning potential and have energy to play and be kids.

The Children’s Sleep Center is one of the only pediatric-centered programs in the region and one of only a handful that is nationally accredited by the American Academy of Sleep Medicine.

Patsy is a pediatric nurse practitioner in infectious disease and the director of infection prevention and The Children’s Immunization Project at Children’s Hospitals and Clinics of Minnesota.

Update

Influenza is now “widespread” in 35 states, including Minnesota.

There is still time to get vaccinated if you and your family have not yet done so.

To learn more about how Children’s is helping prevent the spread of influenza in the community, click on over to www.childrensMN.org/flu.

This post originally appeared on the Mighty Blog on Jan. 2.

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As of Jan. 2, 2014, the Minnesota Department of Health has declared influenza “widespread” across the state, the highest designation level. Over the past two weeks, influenza cases at Children’s have more than doubled, however they still remain below where they were at this time last year. Now that influenza has arrived, it’s likely that it will remain in full swing in Minnesota for the next two months.

So what can you do? The No. 1 way to prevent the flu is to get vaccinated. And it’s not too late. Anyone 6 months of age and older who has not received their flu vaccine should do so now. Most clinics and pharmacies are still vaccinating and have a good supply of vaccine. The most common influenza strain we’re seeing is the H1N1 strain which is contained in this year’s vaccine. In addition to getting the vaccine, we also recommend frequent hand washing and avoiding touching your eyes, nose or mouth prior to washing your hands to help prevent the spread of illness.

If the flu has already reached your house, here are few helpful tips for caring for your child while they’re ill.

What’s the difference between the cold and the flu and how can I tell?

Sometimes it’s hard to know whether a child has a cold or the flu because she may cough, have a runny nose, sore throat and fatigue with both. However with the flu, a child tends to have a high fever which comes on more suddenly and may include severe fatigue and body aches. Colds tend to come on more gradually, and many kids may feel well enough to keep playing and going to school with a cold. Clinics may use a rapid nose swab test to determine if someone has influenza.

What should I do if I suspect influenza?

Most cases of influenza are mild and can be managed at home with rest, plenty of fluids, and fever-reducing medicines. Tender-loving care is good medicine, too. Most over-the-counter “cough and cold” medicines do nothelp a sick child get better faster and won’t have much effect on influenza. Sometimes, the flu can make a child very ill and a visit to the clinic or emergency room is necessary.

When should I take my child to the emergency department?

Take your child to be checked if they have difficulty breathing (fast, grunt-sounding, noisy breathing or small breaths), if their color looks bad (pale or bluish), if they aren’t drinking fluids often or urinating at least once every eight hours, or if they just aren’t themselves and you’re worried. Signs of dehydration are dry lips, sunken eyes, sleepiness or crankiness. Children who seem like they’re getting better and then suddenly get worse should be taken to the Emergency Department immediately. This could mean they have another infection such as pneumonia in addition to the flu.

What are the best ways to get my child’s fever down when she has the flu?

Fever is one of the tools our immune system uses to kill germs. However, children with high fever can feel quite miserable, get crabby, have trouble waking up and may drink less fluids causing dehydration. If you can’t keep the fever down with a fever-reducing medicine such as Tylenol or ibuprofen, then the child should be taken to the clinic or emergency department.

Is there anything else I can do to help make my child more comfortable?

You can keep your child home from day care, school, sports or other activities and have them rest early in their illness until they show signs of getting back to “their normal.” If your child doesn’t want to eat regular meals, don’t insist, but do make sure they drink small amounts of fluids every hour to prevent dehydration.

Is there anything I can do to help my child recover more quickly?

There is an anti-viral medicine called Tamiflu that can be given to children as young as 2 weeks of age. This is used if the child is hospitalized with moderate or severe influenza or if the child is outpatient but at higher risk for complications from influenza. These would be children with immune system problems or neurological, pulmonary, or metabolic underlying conditions. Tamiflu works best if given in the first two days of illness which can cut the severity and number of days of illness in half.

How long will my child be contagious?

Influenza is most contagious the day before symptoms present through about day four of illness. Your child should stay home from school during this time. After viral illnesses, kids can have lingering muscle or body aches and really do need time to rest and recover before rushing back to school. They can often pick up other viruses easily and may have a lingering cough as their airway heals. Depending on the severity of the flu, this may be a few days to a few weeks. Most kids recover within a week. Remember that many schools require that your child be fever-free (without the help of medicines) for one to two days before returning to school or day care.

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